Temporomandibular Joint Surgery
The temporomandibular joint
(TMJ) is a small joint located in front
of the ear where the skull and lower
jaw meet, which allows the lower jaw
(mandible) to move and function.
TMJ disorders have a variety of symptoms.
Patients may complain of earaches,
headaches and limited ability to
open the mouth. They may also complain
of clicking or grating sounds in
the joint and feel pain when opening
and closing the mouth. What must be
determined, of course, is the cause.
WHAT CAUSES TMJ DISORDERS?
Arthritis is one cause of TMJ symptoms.
It can result from an injury or from
grinding of the teeth at night. Another
common cause involves displacement or
dislocation of the disc that is located
between the jawbone and the socket. A
displaced disc may produce clicking or
popping sounds, limit jaw movement,
and cause pain during opening and closing
of the mouth. There are also conditions
such as trauma or rheumatoid
arthritis that can cause the parts of the
TMJ to fuse, preventing jaw movement
altogether.
SOMETIMES THE JOINT ITSELF IS THE
PROBLEM
Stress may trigger pain in the jaw muscles
that is very similar to that caused by
TMJ problems. Such patients frequently
clench or grind their teeth at night causing
painful spasms in the muscles and
difficulty in jaw movement. Patients may
also have a
combination of
muscle and
joint problems.
That is why
diagnosing TMJ
disorders can be
complex and
may require different
diagnostic
procedures.
Determining
the cause of a
TMJ problem
is important,
because it is the
cause that guides
the treatment.
THE ROLE OF THE ORAL AND
MAXILLOFACIAL SURGEON
When symptoms of TMJ trouble appear,
an oral and maxillofacial surgeon should
be consulted. A specialist in the areas of
the mouth, teeth and jaws, the oral and
maxillofacial surgeon is in a good position
to correctly diagnose the problem.
Special imaging studies of the joints may
be ordered and appropriate referral to
other dental or medical specialists or a
physical therapist may be made.
RANGE OF POSSIBLE TREATMENT
The oral and maxillofacial surgeon’s
treatment may range from conservative
dental and medical care to complex
surgery. Depending on the diagnosis,
treatment may include short-term
normal
advanced displacement
slightly displaced
medications for pain and muscle relaxation,
bite plate or splint therapy, and
even stress management counseling.
Generally, if nonsurgical treatment is
unsuccessful or if there is clear joint
damage, surgery may be indicated.
Surgery can involve either arthroscopy
(the method identical to the orthopaedic
procedures used to inspect and treat
larger joints such as the knee) or repair
of damaged tissue by a direct surgical
approach.
Once TMJ disorders are correctly diagnosed,
appropriate treatment can be
provided.
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Dr. Anthony Farole, D.M.D.
Philadelphia, PA
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